Echolalia
Finding our children's voice
by Dr. John Adduru, EdD, RN, BCCS
taken from Wikipedia
In my years of teaching and providing therapy for children, I was always taught to correct echolalia by providing the correct responses. However, having encountered many children exhibiting repeated phrases and copying statements from others, I've sought to understand how to best help them.
I always start with a song (if a child is interested) or an artwork to help them build concentration and focus during our sessions. In these sessions, I've observed how a child might repeat a simple "pencil please" over and over again. The message he was sending me was that he wanted to communicate more and feel connected with me. It isn't easy to gauge whether it was just a response or stimming, but it was definitely something I needed to hear. So, I tried modeling and speaking as if I was showing him how I do things and explaining them to him. Yes, he still kept saying the phrase, but it was a moment for building a relationship with him. With that, I've made peace with the fact that echolalia is more than just repetition.
Echolalia, the repetition of speech, is common in children with autism and has been viewed as a meaningless behavior. However, recent research suggests that echolalia serves important communicative functions (Prizant & Duchan, 1981). Studies have identified many functional categories of echolalia, demonstrating its role in facilitating language learning and practical generalization in children with autism (Pruccoli et al., 2021). Echoic behaviors have been observed in neurotypical infants and children, contributing to language development (Pruccoli et al., 2021). Educators play a significant role in identifying and responding to communicative echolalia, and adopting evidence-informed strategies can support students' journey towards self-generated speech (Cohn et al., 2022). These findings suggest a need to re-evaluate echolalia as an atypical communication pattern rather than a stereotypy in autism spectrum disorder.
After completing my studies in early childhood, special and inclusive education, and providing counseling and therapeutic interventions to my clients, I've come to realize that it is equally important to understand how we can best support our children with echolalia. It is not just speech; it is a communication process.
Here are some tips I can share:
Accept echolalia as a form of connection. Studies suggest echolalia facilitates language acquisition and semantic generalization in children with autism (Pruccoli et al., 2021).
Echolalia is not just repeated words; find the meaning. Some parents view echolalia as an expression of neurodiversity and an integral part of their child's identity, challenging the clinical perspective that seeks to modify this behavior (Cohn et al., 2023). It suggests a need to reconsider echolalia as a form of atypical communication rather than a disturbing symptom.
Give the child time to express themselves and wait. Research on echolalia in autistic children suggests it can serve functional communicative purposes and may be leveraged in language interventions. Tamanaha et al. (2004) observed that echolalia in children with Asperger's syndrome often represents interactive behaviors like requesting objects or actions.
When playing and doing activities with them, be extra descriptive in explaining what you do and focus on verbs while doing them. Play-based interventions, particularly adult-facilitated dramatic peer play, can be effective in extending communicative exchanges and developing symbolic language in autistic children (Schuler, 2003). Therapeutic approaches that recognize the functionality of echolalia and use it as a basis for intervention have shown promise in improving communication skills.
Understand their communication needs by also providing visual cues. Visual media and pictures are commonly used to teach language concepts and expand vocabulary for both verbal and nonverbal autistic children (Surya Wijaya Purnama & Dewi, 2022; Muhammad Dalimunte et al., 2022). Social scripts combined with visual cues, such as a "quiet" picture, have demonstrated effectiveness in increasing scripted statements and reducing involuntary and repetitive speech in children with autism spectrum disorders (Ganz et al., 2008).
Be their guide, not their terror. Educators and therapists are encouraged to view echolalia as meaningful and potentially communicative, rather than as a behavior to be eliminated (Cohn et al., 2022). Studies have shown that incorporating echolalia can facilitate language learning, such as in teaching Chinese characters to autistic children (Leung & Wu, 1997). While some approaches aim to modify echolalic speech through operant conditioning (Palyo et al., 1979), others propose making echolalia a starting point for developing more complex communication skills (Tamanaha et al., 2004).
To sum up, we need to make our children feel safe and confident, especially when they want to express something to us. Children need to be seen, heard, and valued. This doesn't mean they can just do whatever they like, and we turn a blind eye, but rather it's about giving them a safe space within the boundaries of our own created agreements and building rapport through trust and meaningful communication.
References:
Prizant, B. M., & Duchan, J. F. (1981). The functions of immediate echolalia in autistic children. Journal of Speech and Hearing Disorders, 46(3), 241-249. https://doi.org/10.1044/jshd.4603.241
Cohn, E. G., McVilly, K. R., Harrison, M. J., & Stiegler, L. N. (2022). Repeating purposefully: Empowering educators with functional communication models of echolalia in Autism. Autism & Developmental Language Impairments, 7, 23969415221091928.
Pruccoli, J., Spadoni, C., Orsenigo, A., & Parmeggiani, A. (2021). Should echolalia be considered a phonic stereotypy? A narrative review. Brain Sciences, 11(7), 862.
Cohn, E. G., McVilly, K. R., Harrison, M. J., & Stiegler, L. N. (2022). Repeating purposefully: Empowering educators with functional communication models of echolalia in Autism. Autism & Developmental Language Impairments, 7, 23969415221091928.
Tamanaha, A. C., Perissinoto, J., & Pedromônico, M. R. (2004). Considerations about echolalia in children with Asperger's syndrome: proposing an approach for language therapeutics. Revista Brasileira de Psiquiatria (Sao Paulo, Brazil: 1999), 26(4), 278-279.
Schuler, A. L. (2003). Beyond echoplaylia: Promoting language in children with autism. Autism, 7(4), 455-469.
Purnama, S. W., & Dewi, U. (2022). Repeated Communication and Echolalia in Autism (A Case Study). Jurnal Basicedu, 6(2), 3123-3129.
Ganz, J. B., Kaylor, M., Bourgeois, B., & Hadden, K. (2008). The impact of social scripts and visual cues on verbal communication in three children with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 23(2), 79-94.
Cohn, E. G., McVilly, K. R., Harrison, M. J., & Stiegler, L. N. (2022). Repeating purposefully: Empowering educators with functional communication models of echolalia in Autism. Autism & Developmental Language Impairments, 7, 23969415221091928.
Leung, J. P., & Wu, K. I. (1997). Teaching receptive naming of Chinese characters to children with autism by incorporating echolalia. Journal of applied behavior analysis, 30(1), 59-68.
Palyo, William J., Thomas P. Cooke, Adriana L. Schuler, and Tony Apolloni. "Modifying echolalic speech in preschool children: training and generalization." American Journal of Mental Deficiency 83, no. 5 (1979): 480-489.
